Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 25/07/06 for Holmwood Care Centre

Also see our care home review for Holmwood Care Centre for more information

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a clean well maintained home for the people who live there. Their bedrooms are personalised with their own photographs, pictures and ornaments. Good links are established with local surgeries and a doctor commented that staff are always helpful and have a good rapport with the clients and represent them well. Another doctor said Good co-operation and communication. Residents say that they like living in the home, feel well cared for and the staff treat them well with respect for their privacy.

What has improved since the last inspection?

Since the last inspection there have been improvements in assessing people`s care needs before they are offered a place in the home. The provision of some staff training has also been improved and the maintenance of the building has addressed areas that needed attention.

What the care home could do better:

Although work to improve the quality of care planning has taken place the documents remain compromised by omissions and a lack of regular reviews and input from residents and relatives. This must be addressed to ensure the staff have the up to date information they need to provide the full care of each person. Medication is generally well managed but there are areas that need attention to ensure the safety of residents There has been an improvement in the provision of training but this needs to continue to ensure everyone has the knowledge and skills to provide the service residents need. Staff also need to regularly spend supervision time with a senior member of staff to discuss the service, the care provided and their own personal development.

CARE HOMES FOR OLDER PEOPLE Holmwood Care Centre 25 Comberton Road Kidderminster Worcestershire DY10 3DJ Lead Inspector Mrs Yvonne South Unannounced Inspection 25th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmwood Care Centre Address 25 Comberton Road Kidderminster Worcestershire DY10 3DJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01562 824496 01562 822935 kim@holmwood.plus.com St Cloud Care Plc Mrs Angela Jean Butler Care Home 60 Category(ies) of Dementia - over 65 years of age (40), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (60), Physical disability (5), Physical disability over 65 years of age (60), Terminally ill (4) Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Accommodation to be used for a maximum of 30 nursing places. Category PD is restricted to persons aged between 55 -64 years. Date of last inspection 6th February 2006 Brief Description of the Service: Holmwood Care Centre is a 60 bedded care home situated a short distance from the centre of Kidderminster. The home has 52 single rooms 43 of which have en-suite facilities and there are 4 shared rooms. Accommodation is provided on three floors with a passenger lift providing access to rooms on the upper floors. The home provides both residential and nursing care, with a maximum of 30 residents requiring nursing care to be accommodated at any time. Residents requiring nursing care are usually cared for on the ground and first floor with residents requiring residential care located on first and second floors. The home is owned by St Cloud care Plc. and the registered manager is Mrs Angela Butler. In the pre-inspection questionnaire received by the CSCI on 14.07.06 the manager stated that the current scale of charges for accommodation and care were £350 to £545. Additional charges are made by the hairdresser. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection incorporates information received by the Commission for Social care Inspection since 06.02.06 and the information obtained during fieldwork on 25.07.06. As the home is large the fieldwork was undertaken by two inspectors and extended over seven and a three quarter hours during which the inspectors spoke to residents, staff, and the manager. A tour of the premises was undertaken. One inspector focused on the residents receiving residential care and the other inspector focused on those receiving nursing care. Prior to the fieldwork the home was asked by the Commission for Social Care Inspection to distribute questionnaires to the residents, relatives and health care professionals. To date nineteen responses have been received. The focus of this inspection was on the key National Minimum Standards and the requirements and recommendation that arose out of the previous inspection. What the service does well: What has improved since the last inspection? Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 6 Since the last inspection there have been improvements in assessing people’s care needs before they are offered a place in the home. The provision of some staff training has also been improved and the maintenance of the building has addressed areas that needed attention. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient information is obtained prior to admission to enable the home to make a decision regarding a new admission. People are only admitted to the home if their needs can be met. Prospective residents, and their supporters, receive the information they need to help them decide if they wish to live in the home. Sufficient staff do not have training in dementia care to fully understand and be able to respond to the implications of the illness. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 9 EVIDENCE: The care records for three people receiving nursing care were assessed. The pre admission assessments covered all the topics required and provided sufficient information on which to base an initial care plan. More information was needed regarding religious needs and end of life wishes. The manager said that she was addressing this. Several documents were either not dated or partially dated. More care needs to be taken over this. Not all residents’ files contained photographs of them. The manager explained that the photos had been taken but were awaiting development. Photographs of residents, staff and wounds are an important part of record keeping and to ensure the records are kept up to date it is recommended that consideration be given to modernising the equipment used so that pictures are quickly available. For example by using a digital camera and the computer. Some equipment (bedrails, pressure care mattress) was not in place prior to admission although the manager said that the items had been ordered. Unfortunately the admissions had had to take place sooner than first planned. The Statement of Purpose and Service Users’ Guide were available in the reception area and the manager confirmed that everyone who came into the home received their own copies. However there was currently no need for these or other languages. The pre-inspection questionnaire confirmed that documents could be made available in different forms such as large print and Makaton if required. Holmwood Care Centre was registered to care for up to sixty (60) persons of whom forty (40) residents may, under the registration categories have a diagnosis of dementia. It was evident that a significant number of residents had care needs including a dementia type illness. The care of older people with a dementia is specialised and therefore the home needs to be able to demonstrate that staff individually and collectively have the skills and experience to deliver the care required. Currently the level of training necessary is not in place, as this was a requirement within the previous inspection this now requires urgent attention. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The care plans do not contain all the information the staff need to guide them in the provision of care. This includes risk assessments, which are not supported by care plans that advise how the risk can be managed or decreased. Medication is generally well managed so that residents receive their prescribed medication safely. EVIDENCE: Residential care A representative sample of care plans appertaining to residents receiving personal / residential care were viewed and assessed during the inspection. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 11 A number of concerns were raised with the manager regarding the care plans and how they linked in with the risk assessments viewed. One resident had an initial care plan however no functional plan of care was in place despite a time lapse of 9 months since admission. The initial care plan, which was in place, was insufficient in that it did not contain the information needed by carers. Care plans did not cover all potential areas of need as listed under standard 3.3 of the National Minimum Standards and therefore gaps were apparent. The information within care plans was scant in places and therefore could not guide staff to enable consist care to be provided. The reviewing of care plans was not taking place on a regular basis. Care plans need to be reviewed on at least monthly or more frequently as necessary to support individual resident’s needs. When care plans are reviewed the documentation specifies a date and signature only, with no space to indicate whether the plan was amended or not. It was nevertheless evident that care plans were not up dated and contained out of date information or action plans. The daily records as well as medical and other professional’s notes were in good order and contained relevant information. From these notes it was possible to glean information not included within care plans; in a number of cases this information was needed in care plans. A Waterlow risk assessment showed that a resident was at a high risk of developing pressure sores. The risk assessment was reviewed regularly as required however no care plan was in place. Therefore having established a high risk carers were not given any instructions to either prevent pressure sores developing or strategies to be employed in an attempt to reduce the overall risk. A similar issue was identified regarding the risk of falls whereby although the risk assessment was redone or reviewed no care plans were in place to demonstrate how the fall prevention strategies were to be implemented. Residents were weighed regularly although no guidance was given as to when to report weight gain / loss. The actual date when residents were weighed was not recorded. Nutritional screening was not taking place and care plans regarding dietary needs were lacking. Information regarding end of life care was weak in the care plans viewed. The registered manager stated that she was currently seeking information from residents’ representatives in relation to this area of care. A letter had been set to all families in June this year seeking information but there had been a poor response to date. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 12 Nursing care Three care records were assessed. The quality of care planning in two was of a good standard however there were some omissions regarding dates and no evidence that residents or their supporters had been involved in their compilation. There was full information in only one of the files seen concerning ‘After Death Wishes’. The third care record was disorganised and incomplete. There was a sudden cessation in the maintenance of some records and a lack of care plans for some needs, and reviews. The manager said that this had occurred as the result of an in-house transfer from the residential to nursing care as different recording systems were used. It was acknowledged that as two systems were in use in the home the full nursing care record system needed to be implemented immediately a transfer occurred to take over from the residential system to ensure up to date care can be provided. The daily records were well maintained, as were the health records. There was evidence of strong links with local surgeries and discussion regarding pain control and health care. The doctors who completed and returned questionnaires answered the questions positively and commended the home for good co-operation, communication, helpfulness and the good rapport the staff had with the residents. Relatives had expressed concerns that continence needs were not being addressed, there was a delay in providing appropriate pressure relieving equipment and there was difficulty obtaining a visit from a NHS chiropodist. There was written evidence in the three files of good communication with relatives but no evidence of resident or relative involvement in the care planning. The management of medication was assessed. The storage facilities were examined and found to be acceptable. However the temperature of the refrigerator was only monitored sporadically. This should be done daily to ensure the quality of medicines is maintained. Some inhalers lacked prescription labels as they had been applied to the boxes and these had disintegrated over time. The pharmacy must be asked to apply the label to the inhaler every time. An unlabeled inhaler should not be used. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 13 The records had not been signed after the majority of prescribed creams and ointments had been applied. These are generally applied by carers as opposed to trained staff who administer other forms of medication and therefore sign the MAR sheets. In order to be able to evidence application of topical items suitable recording systems must be introduced. There is no reason why the care staff should not sign the MAR sheets after they have applied prescribed creams and ointments. When recording the application of creams and ointments in the daily records they must be named. Information regarding any known allergies was not recorded on some MAR sheets seen. The use of some coding on some MAR sheets was incorrect and would make a medication audit difficult. It was evident that some amendments to the MAR sheets were made without having a second person checking the amendment details to reduce the risk of potential errors. A double signature is required for all handwritten entries and amendments. A small number of residents self-administered either all or some of their own medication. No risk assessment assessments were in place within their care plans. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities is provided from which people can choose to participate. Residents are able to maintain their links with the community, religion and family. Residents are able to choose from a varied and nutritional menu and receive good food to their liking. EVIDENCE: The staff who were interviewed said that residents were able to participate in a range of activities organised by the activities organiser every weekday. The activities organiser was employed for 20 hours a week and undertook group activities and individual sessions. The local church representative visited the home monthly and there were visitors from other denominations to minister to their parishioners. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 15 None of the residents came from other countries or had identified religious or cultural needs that needed support. Care records held accounts of resident involvement and some residents went to the local stroke association or out with family and friends. Eleven residents completed and returned Commission for Social care Inspection (CSCI) questionnaires and they all said that the home provided suitable activities. One relative stated that he/she would like to see more outings and social events. The sample menus sent to the CSCI demonstrated that a varied nutritional menu was provided from which residents could make their choices. The questionnaire responses from five residents said that they liked the food, five people said that they sometimes liked the food and one person said that they did not like the food. A relative said that the food seemed very good. The reports made by the responsible individual appointed by the owners of the home, noted that during residents’ meetings issues relating o the food and menus had been discussed and action had been taken by the manager in response. The inspectors observed that meal times were unhurried and the residents who spoke to the inspector said that they were enjoying their lunch. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaint procedure in the Statement of Purpose and Service Users’ Guide ensures everyone has access to the procedure and residents and relatives confidently raise their concerns. Staff are aware of the different forms of abuse, have received training and know how to respond to any concerns that may arise. EVIDENCE: Since the last inspection the CSCI have not received any formal complaints in relation to Holmwood. The pre-inspection questionnaire stated that the home had received 8 complaints in the past twelve months. These had been investigated and four were found to be substantiated and four were unsubstantiated. Records relating to recent complaints received by the home were well documented and evidence was available of suitable investigations with both the outcome and action taken suitably recorded. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 17 One resident stated that if she had any concerns or complaints that she ‘would see Matron.’ Thirteen of the questionnaire respondents said that they knew the complaints procedure and how to raise their concerns. One relative was unaware of the complaint procedure and three residents said that they would not know who to raise any concerns with. Following the last inspection the registered persons were required to provide training for staff regarding the Protection of Vulnerable Adults (POVA). It was pleasing to note from the training matrix that a significant number of staff have received this training over recent months. One of the staff that was interviewed confirmed that she had received training and both members of staff demonstrated that they knew what action they should take if they had concerns regarding the welfare of the vulnerable people who lived in the home. Since the last inspection one member of staff had been dismissed as she failed to complete an application for a check to be undertaken by the Criminal Records Bureau. A second member of staff had left rather than be disciplined. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to live in a clean, comfortable well maintained home that suits their needs. Measures to control and reduce the risks of cross infection are in place. EVIDENCE: Residential care Accommodation for residents receiving residential care was located within part of the first floor and the entire second floor. A large comfortable lounge was situated on the first floor. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 19 A small representative sample of bedrooms were seen, it was evident that residents were able to bring personal possessions into the home with them and lockable storage was available. Bedroom doors were lockable however none of the residents currently held a key to their room. Care plans did not include any reference to whether residents had chosen not to have a key. It was recommended that each person should be offered the key to their room and lockable storage on admission. If this was considered to be inappropriate a risk assessment should be carried out and a record made of the outcome. Communal bathing facilities were practical but rather clinical in appearance. Bathrooms seen were at times used to store pieces of equipment such as commodes, which was a further detraction from their appearance and availability. The provision of storage for large pieces of equipment was limited. The floor covering in one bathroom needed attention following a water leak and the carpet on a back staircase had a number of ridges and therefore needed attention. One resident stated regarding the care home ‘it’s a lovely place, its clean, it’s pleasant.’ Nursing care The home was clean and well decorated. One room was in the process of redecoration. The manager said that the refurbishment programme and upgrade had been half completed. The inspector saw a sample of bedrooms. They were attractive and personalised. Double bedrooms were fitted with privacy curtains and the manger said that there were plans to upgrade one double room into two singles with en-suite facilities in the near future. The communal areas were pleasant and comfortably furnished. Generally the home was well maintained. However it was observed that two taps were dripping, the locker room door did not fit properly and in one bathroom and one toilet the flexible floor skirting had peeled away from the wall and needed to be attended to. The laundry was clean and tidy and infection control measures were in place through the home. Staff were observed to be wearing personal protective equipment but the training matrix indicated that only seven people had received infection control training. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient appropriately recruited staff are employed in the home to provide the care the residents’ need. Despite the lack of core training residents are currently happy with the care they receive. However the lack of training puts the residents, staff and quality of care at risk. EVIDENCE: The home employs a large work force over a wide age range. Many of the staff work part time. This allows for greater flexibility and availability to cover vacant shifts. Some staff have come from abroad and both male and female carers are employed. This enables gender issues to be successfully addressed, as same sex carers are available to assist residents. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 21 The duty rosters indicate that the home is staffed to meet current residents’ needs. However two relatives considered that there was not always sufficient staff on duty. During each day, in addition to the manager, a sample roster indicated that there was always another trained nurse on duty, a senior care assistant or the head of residential care, five care staff for the nursing residents and in the residential section there were five care assistant in the morning and three in the evening. At night there were a trained nurse and three care assistants awake on duty. The home also employed an administrator a handyman, domestic and catering staff. All residents who completed questionnaires and spoke to the inspectors said that the staff were very kind. Two staff were interviewed and their records assessed. The staff were confident and happy in their roles. They said that the manager was good and approachable. “She is always there and has time for us”. The records indicated that both people had completed an application form and been interviewed. Two references were taken up for each person. Results of checks had been received from the Criminal Records Bureau after each person had started work. Both members of staff said that they had ‘shadowed’ another member of staff for at least the first two weeks after they had started work. If there is an urgent need to appoint, then a POVA (Protection of Vulnerable Adults) First check can be requested. However even then the applicant must continue to work under direct supervision until the full check results have been received. The pre inspection questionnaire, training records and staff confirmed that training was taking place. The training matrix highlighted some of shortfalls, which needed action as well as other areas where training had taken place. Infection awareness training was required by the majority of staff while moving and handling was required by some newly appointed members of staff. An update in fire awareness training was needed for staff; the registered manager undertook to have this in place prior to the end of July 2006. At the time of the inspection the home had 11 out of 40 carers trained to at least NVQ (National Vocational Qualification) level 2 accounting for 27.5 of carers. This falls short of the expectation that 50 of carers would have achieved an NVQ level 2 by the end of 2005. However an additional 10 carers were reported to be currently undertaking this training therefore the above expectation could be met by the end of 2006. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 22 These students may have undertaken some core training as part of their NVQ work and this does not show in the training matrix. The lack of training in infection control and dementia care is of concern. A requirement for dementia care training has twice failed to be met. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from an experienced stable management and the staff are able to seek advice when needed. Further benefit would come from regular supportive sessions (supervision) between the staff and the manager. A quality assurance system, when fully implemented, will identify areas for future improvement and development. The residents live in a clean, well maintained and furnished home that meets their needs. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager has been in post for two and a half years. She is a trained nurse and a health and safety trainer. Recently she has achieved the Registered Manager’s Award. She was well thought of by staff and residents. A quality assurance manual was seen. This was easy to understand and follow and the manager said it was in the process of implementation. Questionnaires had been distributed to the able residents and the activities organiser was helping those people who needed assistance to complete them. It was observed that responses were being received. The home does not routinely hold money in safe keeping for residents, preferring relatives to carry out this function. The home’s ‘Head Office’ invoiced relatives direct for any expenses such as hairdressing. Some cash was however retained for four residents. The record held regarding one residents money was viewed and the balance held checked. These were found to be satisfactory. The need to have two signatures for all transactions does however need to be reiterated. The staff who were interviewed and the manager, confirmed that the supervision programme had not been working effectively. However a new system had been devised and a concerted effort was being made to address this. Most staff had had their annual appraisals and this was noted in the responsible individual’s report in July. A certificate evidencing the testing of fire extinguishers was in place; this recommended that some be re-sited. The fire alarm was last tested prior to the inspection on 29th June 2006 therefore a period of 3 ½ weeks before; this test should be done weekly. Following the inspection the registered manager sent confirmation to the CSCI that the alarm was tested the following day. A container of sanitizer was unsecured with an unlocked sluice room. This was drawn to the attention of the manager and dealt with. The handy man was away on holiday but in his absence assistance had been obtained from another home. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 25 Recently a representative from the Wheelchair Loans department had visited the home and identified that the majority of wheelchairs in general use had been loaned to people who were no longer in the home. In addition they needed to be serviced. They were all taken away leaving the home very short of equipment. This situation had been rectified as soon as possible by the purchase of new wheelchairs. The pre-inspection questionnaire indicated that maintenance and servicing of other equipment was up to date. Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 OP3 OP8 Regulation 13, 14, 15, 16 Requirement Care plans must be drawn up and appropriately reviewed with the involvement of residents or their representatives and include all aspects of care as identified through assessments and risk assessments. Medication must be managed in accordance with the regulations, standards and the home’s policy and procedure. All staff must receive up to date training in all core aspects of care and other relevant areas. Written records must be kept of training Outstanding requirement from last two inspection visits. Care staff must receive formal supervision at least six times a year that includes • all aspects of practice, • the philosophy of care in the home, and • career development needs. Timescale for action 01/12/06 2 OP9 12,13,14, 17 12, 18 01/12/06 3 OP28 01/12/06 4 OP36 18 01/12/06 Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holmwood Care Centre DS0000004119.V303518.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!